Dispenser for surgical ligatures



May 31, 1960 LA VERN E. RUNKEL ETAL 2,933,524

DISPENSER FOR SURGICAL LIGATURES Filed June 18, 1957 F IG. 4

F I G. 7

a T S Y mmms N TUEK PM MRB A EC a m C f Y. ND E mms m wu O uw w w ADISPENSER FOR SURGICAL LIGATURES LaVern E. Runkel and Richard C. Berry,Madison, Wis., and Willis C. Oaks, Rochester, N.Y., assignors to AirReduction Company, Incorporated, New York, N.Y., a corporation of NewYork 7 Filed June 18, 1957, Serial No. 666,389

4 Claims. (Cl. 206- 63.3)

..This invention relates to dispensers for surgical strands, such asligatures and the like, and particularly to a dispenser having a reel onwhich a strand is wound and from which the strand is suppliedsubstantially free of kinks, waves and undue bends.

Surgical strands, such as ligatures, which are employed in surgicaloperations necessarily must be delivered to the site of use in a sterilecondition and be otherwise physically suitable for their intendedpurpose. In conventional practice, the strands are sterile when broughtinto the operating room and are kept in readiness until required, suchas by placing the sterile strands in a receptacle containing a suitablesterilizing or aseptic fluid. Commercially presterilized surgicalstrands, of the type now widely used, come in tubes or vessels in whichthe strands are contained in a suitable sterilizing and conditioningfluid. Such strands are usable directly from their Container. Regardlessof the particular practice followed, however, the strand, when it iscalled for by the surgeon, must be taken, quickly and efiiciently, fromits place of readiness and given to the surgeon for use without delayand with a minimum of handling or risk of contamination.

It has been found, however, that the prior processing of the strandsduring manufacture, which frequently involves coiling or winding thestrands to facilitate packaging and shipment, tends to impart kinks orbends to the strands. In many cases the strands are relatively tightlycoiled, such as on a spool or the like, and they furthentend to coil upon themselves when dispensed. These characteristics are especiallyapparent in the case of strands of the proteinaceous type which possessan inherent stiffness. Such qualities have rendered difficult thedispensing of the strands and it will be seen, not only make thehandling cumbersome, but, also, increase the risk of contamination.These problems'are amplified in the case of ligatures which are in theform of elongated strands that are cut off into shorter lengths asneeded at the time of dispensing.

There have been some methods and devices proposed to facilitate thedispensing of surgical strands in the operating room. However, suchpreviously suggested means generally involve either the manipulation ofan entire length of the strand in a cumbersome manner, or require thehandling of the strands in a tightly wound form in which the undesiredkinks and bends are exaggerated. Although the packaging of the strandsin coil form has several advantages, the ordinary means heretoforeavailable to handle these strands, readily, when .unpackaged for usehave been unsatisfactory. In most instances the proposed dispensingdevices have involved mechanical means, the assembly and operation ofwhich are in themselves cumbersome and they are diflicult' to cleanseand sterilize properly for surgical use.

Accordingly, it is an object of the present invention to provide meansfor dispensing surgical strands, such as. ligatures, in which thehandling required in delivering the strand to the surgeon and the riskof contaminanited States Patent Patented May 31, 1960 l ce tion thereofat the time of putting it to use is It is another object of the presentinvention to provide an improved means for dispensing surgical strands,such as ligatures andthe like, wherein a strand may be provided incoiled form and unwound as it is needed for use in a simple andexpedient manner, such that the sterile condition thereof is readilymaintained and the dispensed strand is free of kinks, waves or unduebends.

Another object, of the invention is to provide a dispensing meansemploying a flat, circular reel having spoke-like tabs forming a windinggroove around its periphery within which a coiled surgical strand iswound, and a dispenser case adapted to contain such reeled strandwhereby an outer end of said strand may be pulled from said dispenserand unwound from the reel in desired lengths.

A further object of the invention is the provision of such a dispenserhaving a wound suture carried on a reel which is freely rotatabletherein, which may be readily disassembled for recharging and in whichthe reel is retained and guided without the requirement of complicated,auxiliary mechanical means. A further object of the invention is toprovide such a dispenser wherein said dispenser case substantiallycompletely encloses the reel, without abrasive contact between said caseand the wound strand, and wherein an opening in said case through whichthe strand is fed is automatically oriented with respect to said reel soas to avoid any binding engagement between said case and said reel.

A still further object of the invention is to provide means in such adispenser for affording regulation by manually imposed frictionalretention means to facilitate the withdrawal and severance of desiredlengths of the strand.

A still further object of the invention is to provide such a dispenserwherein said case is comprised of a substantially thin, cup-shapedmember having a simple removable cover, free of crevices or operatingparts such that said device may be readily cleansed and sterilized in apractical manner for operating room use.

These and other objects and advantages of the invention will be apparentfrom the following detailed description of a preferred form of theinvention, taken in conjunction with the accompanying drawings, inwhich;

Fig. l is a front elevational view of a dispenser case adapted toreceive a reeled surgical strand in accordance with the invention;

Fig. 2 is a vertical section taken along the line 2-2 in Fig. 1illustrating the internal construction of the dispenser case and itsremovable cover portion;

Fig. 3 is a perspective view, partially in section, and broken away,illustrating a dispensing device, in accordance with the presentinvention, including a dispenser case and a reeled strand rotatablycontained therein;

Fig. 4 is a front elevational view of the dispenser seen in Fig. 3, withthe cover removed, illustrating the position of the reeled strand withinthe dispenser case;

Fig. 5 is a vertical sectional view taken along the line 55 in Fig. 4illustrating the position of the reel within the assembled dispensercase and showing the relationship of the discharge opening through whichthe strand is withdrawn;

Fig. 6 is a detail view showing the formation of discharge opening inthe wall of-the casing; and,

Fig. 7 is a perspective view, partly in section, and broken away,illustrating an alternative form of a dispensing device constructed inaccordance with the invention.

Referring to the drawing, a dispenser is shown in Fig. 3, designatedgenerally by the numeral 10, which it will be seen, includes a dispensercase 12 and a reel member 14 contained therein. A surgical strand suchas a ligature 16 which is carried on the reel in the form of a coil isunwound therefrom in use and drawn through an opening 18 in the sidewall190f the dispensercase. a 7

The dispenser case, best shown Figs. l and2, comprises a circularcup-shaped body portion 20 which open onone side. A fitted coverf22having annular flange. 24 which. surrounds the upturned" sidewall -19 ofthe cup 20, and is preferably frictionally sea'ted thereon, formsa'removable closure for the chamber 25 in which a reeled strand isadapted to be contained; Thedispenser case and removable cover thereforpreferably are made of a thin gauge metal whiclris suflici ently rigidto resist deformation under normal handling'and which may be sterilizedby autoclaving; Oppositely disposed central openings '26 and 28 in thecover 22 and easing body 20, respectively, are provided ,for reasonswhich will become apparent as the description proceeds. H Referring nowto Fig. 4, the manner in which the reel 14 is received in the dispensercasing will be more easily observed. The reeled strand formed by thereel blank 14'and strand 16 wound thereonis particularly adapted for usein connection with "the present invention and-is substantially identicalto the reeled strands shown and described in the 'co-pending applicationSerial No. 666,- 390 of R. Berry'and L. Runkel for Package for SurgicalStrands, assigned to the assignee of the present application and filedon the same date as the present application. The .reel 14is in the formof a thinyflat disc having a flat, substantially circular central bodyportion 30 around the periphery of which are provided circumferentiallyspaced, radially extending tabs 32. The adjacent tabs, as illustrated bythe tabs 32', 32", are bent oppositely outof the plane of the centralbody portion to provide a substantially circular groove lying in theplane of the central body portion to receive the turns of the woundstrand. The geometry of the reel is such that the strand,

members 32 against the inner surface of the side wall 19 so that it willeasily revolve within the casing when the outer end of the wound strand16 is pulled through the opening 18. It will be seen that, by theprovision of this type of bearing engagement for support of thedispensing reel within the case 20, substantially no manipulation vofaccessory devices for holding or securing the reeled strandwithin thedispenser is required. Once the free end of the wound strand 16 isthreaded through the opening 18, the reel automaticallyaccommodatesitself within the casing, allowing the strand to be pulled oif of thereel'at 'will. In withdrawing .the strand,"with the opening 18 in theposition shown in Fig. 4, the reel will tend to move toward the ,righthand side of the casing such that the ends of the radial tabs 32 bearmostly against the right side and lower right side of the innersidewall19.

The number of radial tabs and the bearing surface provided attheir-outer ends is sutficient to provide a continuous sliding contactagainst the inner wall of the casing as the reel rotates and preventjamming of the tabs in the casing which might result from too great aspacing therebetween. A reel, as shown, having eight equally spacedtabs, the widthfof the tabs being such'that the total circumferentialextent of their outer ends corresponds approximately to one half thereel perimeter, has been found highly advantageous for the-purposes ofthis invention. Preferably the ends of the tabs are rounded slightly 'toprovide a curvature whose radius corresponds approximately to the radialdistance from the center of the reel.

The opening 18 through which the strand is withdrawn from the casing ispreferably formed substantially midway'in the side of the cylindricalwall 19 as may be seen, for example, in Fig. 5. V The flange 24 of "thedis}- when wound thereon and removed therefrom for subsequent use, .isfree of kinks, sharp bends and waviness, as described in theabove-mentioned co-pending application Serial No. 666,390. This form ofreeled strand is particularly advantageous also in that the strand, whenremoved therefrom, does not tend to spring back into a tightly coiledcondition due to the larger diameter of its coil windings, and itshandling and dispensing for use in ligating, or other purposes, is thusfacilitated. The strand 16 is applied to the reel preferably by fixingits inner end at the innermost part of the coiled strand and thenprogressively winding the strand around the radial tabs as abovedescribed until the entire length of the strand has been received on thereel. Preferably the .outer free end of the strand is then tucked inbetween the side of the Wound coil and a proximate tab, the resiliencyof the tab serving to retain the free end of the strand until it isdesired to dispense the strand at the time of use.

The particular reel, forming a part of the dispenser device of thepresent invention, in addition to conveniently and compactly retaining alength .of the suture strand in a manner rendering it free from kinks,bends and tight coils at the time of use, is also highly advantageous inthat it facilitates the removal of the suture strand therefrom. It willbe noted also that the central body portion 30 of the reel is arrangedto accommodate The reel is thus freely rotatable within the casing andis guided by'the bearing of the ends 36 of its radial tab penser coveris so related thereto that it does not over; lie the opening when thecover is in place. Such positioning of the opening 18 assists in theprevention of the ends of the peripheral tabs 32 of the reel fromcatching or binding on the edge of the opening. Thus, as shown in thisfigure, the adjacent, oppositely bent 'tabs of the reel are disposed, asa ,result ofthe construction of the reel, slightly out of the plane, andon either side, of the coiled strand. The opening 18 is of only slightlylarger size than the strand 16 so that the tabs, thereby, are me;essarily prevented from coming intoalignment with the opening '18 aslong as the strand 16 is threaded through the opening. It may be seen inthis view that, as each tab rotates to an angular position correspondingto the location of the opening 18, the wound strand being main tainedsubstantially in planar alignment with the open: ing causes thesuccessive tabs to pass on either side thereof. Any possible engagement,or catching of the tabs with the edge of the opening is therebyprevented. The construction and arrangement of the reeled strandcooperate in a special way to prevent friction and possible abrasion ofthe strand against the interior of the case when the strand isdispensed. Thus, it will be seen, for example in Fig. 5, that thesidewise projections of the tabs-around. the periphery of the reel, oneither side of the coiled strand space .the strand from the opposing endwalls of the reel chamber 25. The strand, therefore, is prevented fromdirectly bearing on the end walls as the reel rotates. Similarly, theradial projection of the tabs beyond the .coiledstrands eliminatesfrictionalcontact of the strands against the inside of the cylindricalwall 19 of the dispenser case.

' In order to avoid abrasion of the surgical strand .as it ispassedthroughthe-opening 18 audio order further to avoid any possiblebinding of the reel, the cylindrical wall 19, immediately-surroundingthe opening .18. is .extruded slightly in the form of a slight, outward,.conical protrusion 38 as shown in the detail view of Fig. 6. The edgesof-the casing definingthe openingare preferably suitably rounded off, soas to avoid any abrasion'of the strand as it is pulled therethroughduring the dispensing of the strand.

An alternative form of the casing body is shown in Fig. 7 which isidentical to that above described, but wherein a slot 18', extendinginwardly from the open side of the body 2%), is provided in place of theopening 18. In this form of the dispenser the cover 22 extendsdownwardly over the upper end of the slot 18 but not to the bottomthereof, such that an opening is provided, between the edge of the coverand the bottom of the slot, through which the strand is extracted as inthe device hereinabove described.

In use, the dispenser case is sterilized by any suitable means such asautoclaving in the manner conventionally employed for the sterilizationof the usual surgical instruments. The dispenser case then may be placedalong with the other surgical instruments that are to be used in theoperation or other surgical procedure. At the proper time, a desiredsize and type of suture, wound on a suitable reel as herein described,is placed within the open casing and the free end of the surgical strandthreaded through the opening 18. It will be seen that the outwardprotrusion 38 is also effective to assist in threading the strandthrough the opening. In the case of the device shown in Fig. 7, thestrand is simply laid in the slot 18'. The cover 22 is then placed overthe casing and the strand withdrawn as it is needed. The openings 26 and2S permit the central body portion 30 of the reel to be grasped, such asby grasping between the fingers as seen in Fig. 5, so that the rotationof the reel may be regulated at will as the strand is stripped from thereel. This greatly facilitates the holding out of the strand to allowthe nurse or assistant to cut off the strand and facilitates the propergauging or dispensing of the desired length thereof for ligatingpurposes. When the entire length of strand has been consumed or, if itis desired to substitute a reeled suture of a selected size or type, thedispenser is readily disassembled by pressing inwardly against the reelthrough either of the openings 26 and 28, while holding the oppositepart of the dispenser, which thereby forces apart the cover 22 andcasing body 20.

-t will be apparent that while the invention has been described in apreferred form, changes may be made without departing from the spiritand scope of the invention as defined in the following claims.

We claim:

1. A dispenser case adapted to contain and dispense a surgical strandcarried on a circular reel having a peripheral groove within which saidstrand is wound, said case comprising a cylindrical, cup-shaped bodyportion defining one end wall and the cylindrical side wall of saidcase, and a removable cup-shaped cover seated over and forming a closurefor the open side of said body portion and defining therewith acylindrical chamber within which a strand-containing, circular reel isadapted to be substantially concentrically placed so as to be freelyrotatable therein, said body portion having an outward, radialprotrusion in its cylindrical wall in which is formed a substantiallycylindrical bore, said bore constituting a discharge port through whicha strand is adapted to be dispensed, and digital receiving openings inopposing end walls of said case formed by said cover and body portion,said openings being substantially concentrically disposed in said caseand in confronting relation to permit manual pressure to be appliedagainst both sides of a reel contained in said case.

2. A dispenser case according to claim 1 wherein said cover has anannular rim bearing frictionally against the outer surface of saidcylindrical side wall of said body portion to render said assembled,separable members substantially self retaining.

3. A dispenser for surgical strands comprising, in combination, a thin,flat reel having a surgical strand wound thereon, said reel comprising asubstantially circular, central body portion around the periphery ofwhich are provided circumferentially spaced, radially extending tabs, atleast a plurality of which tabs are oppositely bent out of the plane ofsaid central body portion to provide a substantially circular groovelying in the plane of said central body portion, the strand turns beingdisposed in said groove, and a cylindrical case within which said reelis unattachedly disposed, said case being of substantially thincross-section, having opposing, substantially flat, end-walls, betweenwhich said reel is disposed in substantially parallel relation thereto,and a cylindrical sidewall of slightly larger diameter than said reel,said cylindrical wall portion having a discharge opening through whichthe outer end of said wound strand is adapted to be passed, said reelbeing rotatably guided within said case by the co-action of the ends ofsaid tabs and the inner cylindrical sidewall of said case to supportsaid wound strand in said case out of contact with said cylindricalsidewall and rotate freely when said strand is pulled through saidopening, thereby permitting said strand to unwind from said reel, andsaid cylindrical case being provided with means forming oppositelydisposed openings in said end walls in confronting relation to thecentral body portion of said reel, through which said reel may befrictionally engaged to regulate the rotation of said reel when saidstrand is unwound therefrom.

4. A dispenser according to claim 3 wherein said case comprises ashallow, cup-shaped body portion, open at one end, and a removable covertherefor, forming one of said end walls, said cover having an annularinturned edge which is received on said cylindrical side wall, and saidopposed openings are formed respectively. in said cover and in said bodyportion.

References Cited in the file of this patent UNITED STATES PATENTS1,123,497 Davis Jan. 5, 1915 $1,908,278 Angell May 9, 1933 2,343,064Kjorsvik Feb. 29, 1944 2,391,301 Dukehart Dec. 18, 1945 FOREIGN PATENTS495,109 France June 18, 1919 314,147 Italy Jan. 18, 1934

